A 55-year-old man known case of stable angina is brought to the emergency department because of compressive chest pain for 3 hours. The pain is radiating to left arm and was not relieved try rest. Physical examination shows that his blood pressure is 145/80 mmHg and his pulse 80/min, no jugular venous distension, no bibasilar crackles and normal heart sounds are heard. His cardiac enzymes are negative, and his ECG shows no ST-segment elevation. Which of the following is the most likely diagnosis?
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الإجابة: C. Unstable angina
Prolonged ischaemic rest pain (3 h, not relieved by rest) in a known angina patient, with no ST elevation and negative cardiac enzymes = unstable angina. NSTEMI looks the same on ECG but has positive troponin; STEMI needs ST elevation. There are no signs of shock (normal BP, no crackles) and nothing suggesting pericarditis.
ليش كل خيار صح أو غلط
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A
ليش غلط
Cardiogenic shock presents with hypotension and multisystem organ failure from low cardiac output; his BP is 145/80.
✓ 4• Coronary Artery Disease [Notes].pdf · p. 4 -
B
ليش غلط
NSTEMI also has no ST elevation but has positive troponin and CK-MB from tissue destruction; his enzymes are negative.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8 -
C
ليش صح
Unstable angina has no ST elevation and negative troponin and CK-MB because there is no infarction.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8 -
D
ليش غلط
STEMI shows ST elevation on the 12-lead ECG with positive troponin; his ECG has none.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8 -
E
ليش غلط
Pericarditis pain is sharp and aggravated by cough, breathing or position; his pain is compressive, radiates to the left arm and persists at rest.
✓ Ischemic heart disease.pdf · p. 11
- المصدر
- (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8
Step-Up To Medicine 6th (IHD & ACS).pdf · p. 11 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
- ظهر في
- Cardio bank